Transgender people currently struggle to access the healthcare they need and deserve in Aotearoa, but researchers say a new healthcare “hub” could help solve some of these issues.

In an article published in the New Zealand Medical Journal today, the Professional Association for Transgender Health Aotearoa (PATHA) says transgender people face several barriers to healthcare.

PATHA President Jaimie Veale told TVNZ’s Breakfast programme people often don’t know where to access this care or can’t afford it, especially when it comes to surgery. Other times, she says, people are simply too scared to access this type of care.

Veale says Aotearoa is behind many other countries when it comes to transgender healthcare.

For example, the national Gender Affirming (genital) Surgery (GAgS) Service only gets funding for 14 surgeries per year.

At that rate, it would take GAgS more than 27 years to clear the current waitlist for this type of surgery.

Veale says when she shares those sorts of statistics with colleagues at overseas conferences, their jaws drop.

PATHA says many transgender people also currently struggle to access non-genital gender-affirming surgeries through the public system, like chest reconstruction or voice surgery. 

This means New Zealand’s transgender people usually have to pay high costs to have surgery privately. 

For many, this just isn’t possible. Often, transgender people have to fundraise for surgery  through donations from their friends and whānau. 

But transgender healthcare isn’t just about surgery. There are many other needs, including puberty blockers, fertility preservation, gender-affirming hormones, psychosocial support, hair removal, and voice therapy. 

Transgender people also see a gap in how they are treated within the health system.

PATHA says more than a third of transgender people in Aotearoa have avoided seeing a doctor because they were worried about being disrespected or mistreated. 

So, as well as helping increase the number of gender-affirming treatments, PATHA says a centralised transgender health resourcing hub could offer healthcare providers training and other resources to make sure all health needs are met.

The organisation also proposes the use of peer health navigators to help remove a healthcare barrier. 

Peer health navigators are those who have been through similar experiences and can help guide and support other transgender people through the process.

Veale says there are some really good practises emerging in some parts of the country.

“So we think we should learn from some of those good practises already happening regionally and create a national resourcing hub to coordinate and share what’s working well.”

Eliminating the “postcode lottery”

PATHA says there is currently a “postcode lottery” across regions when it comes to accessing transgender healthcare needs.

The group is proposing a “hub-and-spoke” type model where some care, such as hormone treatment, is delivered locally, while other care, such as surgery, is delivered regionally or nationally. 

But Veale says it’s important that people are able to get the care they need within their own region.

“We need a plan for as many people as possible to access the care with their local doctor or hospital,” she says.

Veale says being able to access adequate health care will make a huge difference in the lives of New Zealand’s transgender people.  

“We know when people are supported and not facing barriers to the healthcare they need and they’re supported by their families and their communities, then they are doing much better.”

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